Baking…it’s not brain surgery

I’ve been baking (did the title give it away?) over the past weekend, and it has been great. So far I’ve made peanut butter cookies and beetroot chocolate cake. I also got to do some cooking, and made duck with almonds from an old Chinese recipe cookbook, which turned out pretty good. There was no easy road with this duck though, as it was a duck crown, and the meat had to be taken off the bones. It wasn’t my first time doing this, so I’m starting to get a feel for it, and it’s not that difficult. But like many things, it can be time consuming. If you’re cooking anything with chicken, give chicken thighs a go. They can be de-boned pretty easily if you have a small, sharp paring knife (big knives are too clumsy, and have the tendency to almost cut off my fingers) and the meat is quite different to the usual stuff. Thighs are significantly cheaper, though it is a trade-off between convenience and cost.

The cookies were a recipe from our very own Paul Rankin – a soft, sugar/peanut butter cookie that is incredibly easy to make and pretty good. It’s a good basic recipe, that could easily be adapted with chocolate chips and other additions, or they could even be iced. Cayenne, Rankin’s only remaining restaurant, and his flagship, has always interested me. I don’t know whether I could justify the price, but it would be nice to go at least once to see if it lives up to my expectations. My expectations have been markedly lowered in recent years, as much of the food when dining out isn’t worth the money, and just leaves me thinking about what an amazing meal I could make with much less money. The beetroot cake (recipe here) was inspired by a friend, who recommended it, and I was obligated to try it. “Beetroot…in a cake?” you may say, but like many vegetable based cakes, turned out to be good. Next time I would add some cocoa powder, and make the icing slightly more solid, but in general it turned out well. The icing…oh, the icing. White chocolate, icing sugar, and soured cream combined to form an amazing cream frosting that remained soft throughout. The texture/crumb structure of the cake improved, suprisingly, over the week and stayed moist, while the beetroot flavour became somewhat more prominent. It was still a nice balance between beetroot and chocolate, and fresher beetroot might help the cake in a future endeavour. Mum grows beetroot, so we have an endless supply.

KVM Switch Diagram

Now we have to talk about some technology; a piece of technology that has been knocking about since the late 1980s/1990s, but you might not even have noticed before. Here’s a hypothetical: you’ve got two computers, a work computer and a gaming computer, but your computer space is shared between the two machines, and you only have one monitor, keyboard, and mouse. What do you do? Give up, of course, because switching the cables over every time you want to use the other computer is enough to drive anyone to insanity. But wait! Don’t do anything drastic just yet. Someone already thought of this predicament, and developed a gadget to allow you to share one monitor and peripherals between multiple computers. It is, of course, a KVM switch. KVM stands for keyboard, video, and mouse, and does exactly what it says on the label – it allows you hook up multiple computers, and switch between them, while sharing the same monitor and peripherals. It can also be useful if you are setting up a dock for your laptop, allowing your to switch between your main computer, and laptop when it is docked.

Ventriculo-peritoneal shunt diagram

On to brain surgery! I’m currently placed in neurology in the Royal Victoria Hospital in Belfast and I have completed the first week of my two week placement here, and has had its good points and bad points. There are 27 (as far as I know) of us placed in neurology at the moment, which is a rather large group compared to the last hospitals, where I was one of five students, and had a lot more freedom. In Altnagelvin I could pretty much go and see whatever I wanted, or go to surgery when I wanted, but with so many of us now, slots have to be allocated for surgery and there is a fair amount of waiting around, hoping to get taught something. Don’t get me wrong, the tutorials and the teaching itself is pretty good, but you don’t have the same contact with doctors that you would otherwise have in a smaller group. The highlight of my time has definitely been neurosurgery yesterday, with Mr Cook. I missed most of the first operation, which was a resection of a craniopharyngioma, a brain tumour derived from pituitary gland embryonic tissue. When I arrived they were closing things up, but I got to see the tail end of things, and sat down with the consultant surgeon afterwards who ran through the operation with me as he filled in the report. After that surgery, Mr Cook invited me down to see a ventriculo-peritoneal shunt placement (a shunt draining excessive cerebrospinal fluid into the abdominal cavity) later in the day, which was really interesting too. Shunting is used in hydrocephalus, where the is a faster rate of CSF production than resorption. While surgery is fascinating, I never expect the onslaught of questions from the surgeon. No matter where you are, or what you are doing, if you are a medical student then you will get asked a barrage of questions. And from what I’ve seen, this continues pretty much until you become a consultant. Then, you are exempt from questions and free to do the questioning yourself. This week also highlighted how even consultants don’t know everything, as I got the chance to sit in on a couple of case presentations by registrars of difficult cases. One patient presented with one set of neurological symptoms a few years back which resolved, and is now presenting with a different set of symptoms and different MRI and EEG changes than the last time. Everyone was stumped, and throwing out every possible differential, hoping to stumble across a possible diagnosis. Patients often refuse to fit into neat categories, or any sort of category at all in some rare cases.